2005, 07-11 Permit App: 05002333 Furnace & ACCARD
AUTHORIZED
(J m'w -f 4 tj
MECHANICAL PERMIT APPLICATION
Community
Development Department
L .
Building Division
An Phone: (509) 688-0036; FAX: (509) 688-0037
11707 E. Sprague Avenue, Suite 106
T For Inspections, Call (509) 688-0054
Spokane Valley, WA 99206
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Permit Use: ? 7*"'
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Project
Address: /
Phone (Da 'me
Contact: •
Owner:e A f
Mailing Address: S.
License #:
ty State Zip Code
1hone #: 9.27'F�4/ 71
Contractor:
Mailing Address: l i
c
state z' code
TOTAL AMOUNT
# OF UNITS X
COST =
DESCRIPTION OF WORK
1
FUEL BURNING APPLIANCE Equal to or less than 100,000
X
$12.00 =
2
FUEL BURNING APPLIANCE More than 100,000
X
$15.00 =
3
UNLISTED APPLIANCE Additional Fee Equal to or less than 400,000
X
$50.00 =
4
UNLISTED APPLIANCE Additional Fee More than 400,000
X
$100.00 =
5
USED APPLIANCE SEC min. AFUE rating) Equal to or less than 400,000
X
$50.00 =
6
USED APPLIANCE CWSEC min. AFUE ratio More than 400,000
X
$100.00 =
7
BOILER/REFRIGERATION 1 - 100M BTU
X
$12.00 =
8
BOILERIREFRIGERATION 101 - 500M BTU
X
$20.00 =
9
BOILER/REFRIGERATION 501 - 1,000M BTU
X
$25.00 =
10
BOILER/REFRIGERATION 1,001 - 1 750M BTU
X
$35.00 =
11
BOILER/REFRIGERATION More than 1,750M BTU
X
$60.00 =
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
$10.00 =
X
$10.00 -
13
RANGE
X
$10.00 =
14
DRYER
15
FUEL BURNING WATER HEATER
X
$10.00 =
16
MISC. FUEL BURNING APPLIANCE
X
$10.00 =
X
$1.00 =
17
GAS PIPING each outlet
X
$10.00 =
18
DUCT SYSTEMS
X
$10.00 =
19
VENTILATING FANS
20
AIR HANDLER DOES NOT include ducting) Equal to or less than 10,000 CFM
X
$12.00 =
21
AIR HANDLER DOES NOT include ducfin Greater than 10,000 CFM
X
$15.00 =
X
$10.00 =
22
EVAPORATIVE COOLERS
X
$50.00 -
23
TYPE I HOOD
X
$10.00
24
TYPE 11 HOOD
0O
25
HEAT PUMP/AIR CONDITIONER 0-3 TON
X
$12.00 =
26
AIR CONDITIONER 3-15 TON
X
$20.00 =
27
AIR CONDITIONER 15-30 TON
X
$25.00 =
28
AIR CONDITIONER 30-50 TON
X
$35.00 =
More than 50 TON
X
$60.00 =
29
AIR CONDITIONER
X
$10.00 =
30
LPG STORAGE TANK
31
WOOD OR PELLET STOVEINSERT
X
$10.00 =
32
WOOD STOVE - FREE STANDING
X
$25.00 =
X
$15.00 =
33
REPAIR d ADDITIONS
X
$12.00 =
34
VENTILATION SYSTEMS
35
VENTILATION MECHANICAL EXHAUST
X
$12.00 =
X
$19.00 =
36
INCINERATOR - RESIDENCE
X
$22.00 =
37
INCINERATOR - COMMERCIAL
y
r'
METHOD OF PAYMENT:
SUBTOTAL
DATE:
[I CASH [I CHECK ❑ VISA q MC
PROCESSING FEE $35.00
- A fVIRES: n 'r
TOTAL PERMIT FEE DUE:
CARD
AUTHORIZED
Project Address:
Owner:
Mailing Address:
Contractor:
Mailing Address:
PLUMBING PERMIT APPLICATION
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, Call (509) 688-0054
Permit Use:
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone (Daytime Contact):
City
License #:
City
State Zip Code
Phone #:
State Zip Code
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6.00
=
2
URINALS
X
$6 00
=
3
TUBS
X
$6.00
=
4
SHOWERS PER TRAP
BATH, STALL, ON-SITE BUILT
X
$6.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREPICULINARY MEAT
X
$6.00
=
6
DISHWASHER
X
$6.00
=
7
CLOTHES WASHER
X
$6.00
=
8
GARBAGE DISPOSAL
X
$6.00
=
9
WATER SOFTENER
X
$6.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
$6.00
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
$6.00
=
13
FOUNTAINS, DRINKING
X
$6.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6.00
=
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6.00
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
X
$600
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS
X
$6.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.00
=
19
MEDICAL GAS r outlet
NITROUS, OXYGEN
X
$6.00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
$6.00
=
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
=
METHOD OF PAYMENT:
❑ CASH ❑ CHECK ❑ VISA ❑ MASTERCARD
DATE. EXPIRES:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: